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J Thromb Haemost. 2014 Oct;12(10):1591. doi: 10.1111/jth.12642. Epub 2014 Aug 7.

Iatrogenic anemia (can it be prevented?).

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Department of Medicine, Clinch Valley Medical Center, Richlands, VA, USA.


'Iatrogenic anemia' is a condition of lowered hematocrit and hemoglobin count resulting from large or frequent removal of blood samples, usually for laboratory testing. It is frequently seen in patients who are already suffering from bone marrow depression, and thus may become a comorbidity. Because several different types of chemical agents may be required for test procedures, a large volume of blood could be removed for each set of testing, perhaps 50-60 mL. Often local and reference laboratories request larger samples than are really necessary to perform a given test and still have some left to perform any required repeat testing. My experience shows that a volume of about 3 mL of each type of sample should be sufficient for this purpose.


anemia; clinical laboratory techniques; iatrogenic disease; medical laboratory science; phlebotomy

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